BC-658 Insufficient Information Received to Proceed with Search

BC-658-(L)
(2-28-2019)
OMB NO. 0607-0117:
Approval Expires

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
National Processing Center
Jeffersonville, IN 47132-0001

‰

Re:

Before a search can be made of the census records, it will be necessary for you to furnish us with the exact address and
the name of the parent or other head of household with whom living on the following date:
If living in a city at the time for the census, it will be necessary to furnish the house number, name of the street, city,
county, and State, If residing in a rural area, it is very important to provide the township, district, precinct or beat and
the direction and number of miles from the nearest town. Please enter the information in the spaces provided below or on
the reverse side if additional space is needed and return it to Personal Census Search Unit, PO Box 1545, Jeffersonville,
IN 47131-0001. If the information requested is not received within 90 days, this case will be closed.
Census
date
(a)

Number and street
(b)

City or town

County and State

(c)

(d)

Name of person
with whom living
(head of household)
(e)

JAN 1,
1920*
APRIL 1,
1930
APRIL 1,
1940
APRIL 1,
1950
APRIL 1,
1960
APRIL 1,
1970
APRIL 1,
1980
APRIL 1,
1990

ZIP Code:

APRIL 1,
2000

ZIP Code:

APRIL 1,
2010

ZIP Code:

*Census dated 1920 may be searched if you give only the name of the city, county, State of residence, and the name of the household head on the census date.
However, a more complete address is helpful if extensive searching is required. For all other census listed, it is necessary to give your exact place of residence on the
census date.

census.gov

The average time it should take you to fill out the BC-658, "Insufficient Information Received to Proceed with Search," including
the time spent reading instructions is 6 minutes.
Send comments regarding this estimate or any other aspect of this collection of information, including suggestions for reducing
this burden, to: Deborah Johnson, U.S. Census Bureau, NPC, 1201 E. 10th St., Jeffersonville, In 47132. You may e-mail
comments to Deborah.Johnson@census.gov; use "Paperwork Project 0607-0117" as the subject.
Respondents are not required to respond to any information collection unless it displays a valid approval number from the
Office of Management and Budget. This 8-digit number appears in the top left corner on the front of this form.

The U.S. Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly release
your responses in a way that could identify you or your household. Title 13, United States Code, Section 8(a) permits release to
the person whom the information pertains or to their legal representative. Several Federal laws protect your privacy and keeps
your answers confidential (5 U.S.C. § 552a and Title 13, United States Code, Section 9). Per the Federal Cybersecurity
Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your
data.
The information provided to us may be shared with other Census Bureau staff for the work-related purposes per the published
routine uses as identified in the Privacy Act System of Records Notice COMMERCE/Census-6, Population Census Records for
1910 and All Subsequent Decennial Censuses.
Furnishing this information is voluntary. Failure to do so may affect the Census Bureau’s ability to provide the information
requested.

FORM BC-658(L) (2-28-2019)